论文部分内容阅读
目的:研究慢性肾脏病(CKD)患者血游离脂肪酸(FFA)的变化,并探讨其与标准(常规)血脂谱的相关性。方法:对入选CKD患者236例(非透析)的临床及实验室资料进行回顾性分析。根据K/DOQI慢性肾脏病临床实践指南,通过MDRD简化公式估算肾小球滤过率(eGFR),将CKD患者分为CKD1-5期共5组。收集血FFA及三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白A1(apoA1)、栽脂蛋白B(apoB)、脂蛋白a[Lp(a)]标准(常规)血脂谱等相关数据进行统计分析。结果:入选CKD患者共236例。血FFA水平从CKD1期至CKD5期逐渐升高[CKD1期(0.21±0.05)mmol/L,CKD2期(0.24±0.04)mmol/L,CKD3期(0.35±0.06)mmol/L,CKD4期(0.42±0.10)mmol/L,CKD5期(0.47±0.13)mmol/L],且前后组比较均有统计学意义(P<0.05)。经Pearson相关分析,FFA与TG(r=0.141,P<0.05)、Lp(a)(r=0.225,P<0.01)呈正相关,与apoA1(r=-0.214,P<0.01)、eGFR(r=-0.728,P<0.01)呈负相关。多元逐步回归分析显示,FFA与eGFR(β=-0.714,P<0.01)、apoA1(β=-0.090,P<0.05)呈负相关。结论:FFA可早期反映CKD患者的脂代谢紊乱;可作为评估CKD进展的指标之一;CKD患者血FFA代谢异常可能与apoA1相关,肾功能减退可能是导致血FFA升高的危险因素。
Objective: To investigate the changes of free fatty acid (FFA) in patients with chronic kidney disease (CKD) and to explore its correlation with the standard (routine) blood lipid profile. Methods: The clinical and laboratory data of 236 patients with CKD (non-dialysis) were retrospectively analyzed. Glomerular filtration rate (eGFR) was estimated according to the K / DOQI clinical practice guidelines for chronic kidney disease by dividing the CKD into 5 groups. The serum levels of FFA, triglyceride (TG), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), apolipoprotein A1 (apoA1) B (apoB), lipoprotein a [Lp (a)] standard (conventional) blood lipid profile and other related data for statistical analysis. Results: A total of 236 patients with CKD were enrolled. Blood FFA levels increased from CKD1 to CKD5 [CKD1 (0.21 ± 0.05) mmol / L, CKD2 (0.24 ± 0.04) mmol / L, CKD3.36 ± 0.06 mmol / L and CKD4 ± 0.10) mmol / L, CKD5 (0.47 ± 0.13) mmol / L], and there was a significant difference between before and after treatment (P <0.05). After Pearson correlation analysis, FFA was positively correlated with TG (r = 0.141, P <0.05) and Lp (a) (r = 0.225, P <0.01) = -0.728, P <0.01) was negatively correlated. Multiple stepwise regression analysis showed that there was a negative correlation between FFA and eGFR (β = -0.714, P <0.01) and apoA1 (β = -0.090, P <0.05). Conclusion: FFA can reflect lipid disorders in CKD patients at early stage. It may be used as an index to evaluate the progression of CKD. Abnormal serum FFA metabolism may be associated with apoA1 in CKD patients. Renal dysfunction may be the risk factor of elevated serum FFA.